Parezanović-Ilić Katarina, Jevtić Milorad, Jeremić Branislav, Arsenijević Slobodan
Srp Arh Celok Lek. 2009 Sep-Oct;137(9-10):511-7. doi: 10.2298/sarh0910511p.
The pelvic floor is made of a mutually connected system that consists of muscles, connecting tissue and nerve components. Damage to any of these elements creates dysfunction which is exerted through stress, urinary incontinence, prolapse of genital organs and faecal incontinence.
The primary aim of this study was to present the possibility of objective assessment of pelvic floor muscle force in healthy and sick women using a newly designed instrument, the vaginal dynamometer, as well as to establish the correlation between the values of pelvic floor muscle force obtained by the vaginal dynamometer and digital palpation method.
The study included 90 female patients, age 20-58 years. One group of respondents was made of healthy women (who gave birth, and those who have not given birth), while the other one consisted of sick women (who suffered from incontinence or prolapse of genital organs, operated on or not). The pelvic floor muscle strength of every woman was measured with a newly-constructed device for measuring and monitoring of the pelvic floor muscle force in women, the vaginal dynamometer. Then it was compared with the valid clinical digital palpation (palpation with two fingers) based on the scale for measuring muscle contractions with the digital palpation - the digital pelvic assessment rating scale. The vaginal dynamometer consists of a redesigned speculum which is inserted into the vagina and a sensor for measuring the force.
Statistically significant linear correlation was found in the values of the measured muscle force with the vaginal dynamometer and ratings produced by digital palpation (r = 0.92; p < 0.001). Mean value of the muscle force of the healthy women measured by the vaginal dynamometer was 1.44 +/- 0.38 daN and that value of the sick women was 0.78 +/- 0.31 daN (t = 8.89 for df = 88; p < 0.001). Mean value of the ratings produced by digital palpation in healthy women was 4.10 (95% of trust limits 3.83-4.37), while the value in sick women was 2.41 (95% of trust limits 2.10-4.16) (Z = -6.38; p < 0.001).
The vaginal dynamometer has been presented as an attempt to overcome the limitations of the previously presented techniques for muscle force measurement. The application of the vaginal dynamometer in clinical practice makes objective and numerical assessment of pelvic floor muscle force possible, independent of the subjective assessment of the examiner. The usage of this instrument enables not only the diagnostics of women's pelvic floor muscle problem, but also the objective monitoring of rehabilitation gynaecological medicine results.
盆底由一个相互连接的系统组成，该系统包括肌肉、结缔组织和神经成分。这些元素中的任何一个受损都会导致功能障碍，表现为压力性尿失禁、生殖器官脱垂和大便失禁。
本研究的主要目的是介绍使用新设计的仪器——阴道测力计，对健康和患病女性的盆底肌肉力量进行客观评估的可能性，并建立通过阴道测力计获得的盆底肌肉力量值与指诊法之间的相关性。
该研究纳入了90名年龄在20 - 58岁之间的女性患者。一组受访者由健康女性组成（包括已生育和未生育的），另一组由患病女性组成（患有尿失禁或生殖器官脱垂，无论是否接受过手术）。使用一种新构建的用于测量和监测女性盆底肌肉力量的装置——阴道测力计，测量每位女性的盆底肌肉力量。然后将其与基于指诊肌肉收缩测量量表——数字盆腔评估评分量表的有效临床指诊（双指触诊）进行比较。阴道测力计由一个重新设计的插入阴道的窥器和一个测力传感器组成。
在通过阴道测力计测量的肌肉力量值与指诊产生的评分之间发现了具有统计学意义的线性相关性（r = 0.92；p < 0.001）。通过阴道测力计测量的健康女性肌肉力量平均值为1.44 +/- 0.38 daN，患病女性的该值为0.78 +/- 0.31 daN（自由度为88时t = 8.89；p < 0.001）。健康女性指诊产生的评分平均值为4.10（95%置信区间3.83 - 4.37），而患病女性的值为2.41（95%置信区间2.10 - 4.16）（Z = -6.38；p < 0.001）。
阴道测力计是为克服先前肌肉力量测量技术的局限性而进行的尝试。阴道测力计在临床实践中的应用使得对盆底肌肉力量进行客观和数值评估成为可能，而不受检查者主观评估的影响。使用该仪器不仅能够诊断女性盆底肌肉问题，还能对妇科康复治疗结果进行客观监测。
